TOPIC GUIDE: Smart Drugs
"We should embrace the use of smart drugs"
PUBLISHED: 01 Aug 2013
AUTHOR: Joel Cohen & Helen Birtwistle
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Across the UK students and high-achieving professionals are popping pills. These drugs aren’t being taken recreationally by party-goers but by students cramming for essays and exams, anxious businessmen and those struggling to overcome jetlag. These ‘chemical cognitive enhancers’ known to many as ‘smart drugs’ are still most prevalent in the US but the numbers of people using them in the UK is on the rise according to recent reports. As many as one in ten UK students might now be taking them to get ahead [Ref: Telegraph] prompting heated debate amongst the British medical profession. While leading bioethicist, John Harris, wrote in the British Medical Journal that ‘smart drugs’ should be embraced [Ref: BMJ], others in his field have voiced a range of scientific and moral objections. The turn towards ‘cosmetic neurology’, that is the use of drug treatments by people without disease to enhance normal cognitive abilities, marks an important shift in medicine and raises difficult questions about their use. Should medicine be used to improve the quality of life of those who are healthy as well as those who are sick? Are those who use smart drugs justified in taking credit for a pharmaceutically enhanced performance? Are ‘off-label’ medications an exciting step towards ‘better brains’ or are we in danger of undermining something of ourselves in the quest for perfection?
DEBATE IN CONTEXT
This section provides a summary of the key issues in the debate, set in the context of recent discussions and the competing positions that have been adopted.
Which drugs and for what?
In the development of treatments for neurological disorders like Alzheimer’s and Parkinson’s, researchers were surprised to discover the ‘off-label’ effects of drugs they had developed when taken by healthy individuals [Ref: Guardian]. These drugs are available on prescription for those suffering from such medical conditions, but are also being purchased over the internet and elsewhere by healthy individuals (the legality of such purchases varies from country to country and from drug to drug). They work on the neural processes underlying attention, perception, learning, memory, language, planning and decision-making, usually by altering the balance of the chemical neurotransmitters involved in these processes. Some examples include Modafinil (Provigil), originally intended for sufferers of the sleep disorder narcolepsy, but now widely used to increase attention and replace sleep; Donezipil (Aricept) designed for Alzheimer’s patients but used to boost memory; and Methylphenidate (Ritalin), for the treatment of attention deficit hyperactivity disorder (ADHAD), now used to imp rove attention and lessen distractibility. Proponents argue that their use is just a step-on from the more conventional use of nicotine, caffeine and alcohol people have used for centuries to boost mood, memory and performance. Sceptical bioethicists have, on the other hand, raised doubts over the ethics of medical practitioners offering potentially risky pharmaceutical solutions in cases that amount to the obsessions of the “worried well” [Ref: Dana Foundation].
Are smart drugs dangerous?
Because smart drugs have already been judged safe enough for use in the context of specific treatments, advocates argue we can reasonably assume that they are safe enough to be taken by a healthy adult population for the purposes of enhancement. Dissidents meanwhile warn that the infancy of smart drugs means we cannot yet assume they are safe [Ref: Guardian]. Scientists in the field of human memory worry that smart drugs might irreversibly transform the make-up of – especially young people’s – brain chemistry and human character [Ref: University of Pennsylvania]. Other writers have suggested there might be negative societal effects were smart drugs widespread. Tomorrow”, wrote William Safire pessimistically, “we can expect a kind of Botox for the brain to smooth out wrinkled temperaments, to turn shy people into extroverts, or to bestow a sense of humour on a born grouch” [Ref: Reason]. As the pace of scientific change continues to outstrip public debate, some researchers have argued that better regulation might allow pharmaceutical companies to develop and market cognitive enhancers for healthy adults [Ref: Nature].
Drugs, coercion and inequity
Some believe improved regulation might open flood gates to a new brand of highly developed ‘smart drugs’. These critics worry not that the cosmetic neurology might help individual fighter pilots or surgeons strive for better performance, but that the widespread use of cognitive enhancers might provoke a pharmaceutical ‘arms race’ widening inequalities in competitive environments like the worlds of business or education [Ref: NY Mag] – what starts as a matter of individual choice can quickly become one of collective coercion, warns commentator, Roger Cohen [Ref: New York Times]. In contrast, advocates of smart drugs argue these fears over-estimate the power of pharmaceuticals – just because cognitive enhancement might help you complete a task productively does not mean that task is the measure of success in broader life [Ref: Daily Beast]. Just as the effect of cognitive enhancers can be varied, smart drugs might just as well be used to re-organise one’s music collection as help humanity cure cancer.
Are we cheating ourselves if we use smart drugs?
The technology’s neutrality has led Margaret Talbot to argue that smart drugs “facilitate a pinched, unromantic, grudgingly efficient form of productivity” far removed from the kind of creativity necessary for human advancement [Ref: New Yorker]. Academics concerned for the laziness of their students have similarly seen the use of smart drugs as symptomatic of a broader ‘managerial’ and ‘reductive’ approach to scholarship that promotes rote learning over creativity and underplays the importance of a critical engagement with difficult ideas [Ref: THES]. In this light ‘smart drugs’ at present appear woefully inadequate at provoking the kind of critical engagement with ideas that produces innovation. For the philosopher, Michael Sandel and others, the scientific pursuit of perfection undermines our appreciation for the virtues and ‘giftedness’ of human character [Ref: Atlantic]. The defenders of enhancement argue support for smart drugs is a moral imperative – it is exactly the drive to self-improve transcending natural limits that defines the human character?
It is crucial for debaters to have read the articles in this section, which provide essential information and arguments for and against the debate motion. Students will be expected to have additional evidence and examples derived from independent research, but they can expect to be criticised if they lack a basic familiarity with the issues raised in the essential reading.
Arthur L. Caplan and Paul R. McHugh, M.D. The Dana Foundation 1 October 2004
Sherry Baker Discover Magazine April 2009
John Harris BMJ 2009
Adam Rutherford Guardian 12 December 2008
Henry Greely et al Nature December 2008
Anthony Bradley Acton Institute 16 July 2013
Ann Robinson Guardian 23 February 2010
Paul Cooper Times Higher Education 25 June 2009
Martha Farah University of Pennsylvania
David Edmonds Prospect 3 September 2009
Margaret Talbot New Yorker 27 April 2009
Ronald Bailey Reason February 2003
Definitions of key concepts that are crucial for understanding the topic. Students should be familiar with these terms and the different ways in which they are used and interpreted and should be prepared to explain their significance.
Useful websites and materials that provide a good starting point for research.
New York Times 13 June 2013
Mo Castandi Welcome Trust 20 May 2013
Robert Kolker NYMag 31 March 2013
Roger Cohen New York Times 4 March 2013
Battle of Ideas October 2011
Sharon Begley Daily Beast 3 January 2011
Mun-Keat Looi Wellcome Trust Blog 12 May 2010
Jeremy Laurance Independent 19 June 2009
Madeline Brettingham TES 1 February 2008
The Dana Centre 14 May 2007
Michael Sandel Atlantic April 2004
Links to organisations, campaign groups and official bodies who are referenced within the Topic Guide or which will be of use in providing additional research information.
IN THE NEWS
Relevant recent news stories from a variety of sources, which ensure students have an up to date awareness of the state of the debate.
BBC News 13 August 2013
Telegraph 30 June 2013
The Tab (Leeds) 15 May 2013
BBC News 9 November 2011
Sydney Morning Herald 21 March 2011
Atlantic Wire 21 December 2010
Telegraph 6 July 2010
Daily Mail 8 May 2010
Daily Mail 10 March 2010
The Times 27 February 2010
Metro 21 February 2010
Star Tribune 18 January 2010
Bloomberg 17 March 2009
NPR 5 February 2009
The Times 1 January 2009
Reuters India 16 July 2008
Washington Post 9 April 2008
BBC News 29 May 2007
The Times 4 June 2006
BBC News 9 November 2011
Battle of Ideas October 2011
The Dana Centre 14 May 2007
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